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2008 Social Initiative - Brain Injury |
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By Nancy Benoit RN CRRN CCM CMSNE
Maine Extension Co-Chair
I am pleased to introduce you to
CMSNE’s 2008 Social Initiative “Brain Injury
Awareness”. Throughout the year the Case
Management Society of New England will be working
with the Brain Injury Associations of Maine,
Massachusetts, New Hampshire and Rhode Island to
bring you a variety of programs and opportunities to
increase your knowledge and understanding of brain
injuries and provide valuable resources for Case
Managers and the clients they serve. We will be
inviting speakers to CMSNE for our annual conference
to present information and tools that will improve
outcomes and allow us to assist our clients in
recognizing Brain Injuries and understand ways to
minimize their risks of sustaining a brain injury.
A Brain Injury can be Acquired
– such as an injury to the brain that is not
hereditary, congenital or degenerative or Traumatic
– such as an insult to the brain not of a
degenerative or congenital nature. Causes of Acquired
Brain Injuries include anoxia/hypoxic injury
such as cardiopulmonary arrest, carbon monoxide
poisoning, airway obstruction or hemorrhage,
intracranial surgery, stroke, infectious diseases,
aneurysms, tumors, metabolic disorders or seizure
disorders. A Traumatic Brain Injury is caused
by an external physical force that may produce a
diminished or altered state of consciousness with
resultant impairment of cognitive, perceptual
abilities or physical functioning.
Brain injuries are often referred
to as the “Silent Epidemic” and are a largely
unrecognized major public health problem because
many brain injuries are not even perceived as such
when in fact concussions are indeed a brain injury.
FACT: approximately 1 in 10
individuals are affected by a Brain Injury
FACT: Brain Injury is the leading
cause of death and disability in children and young
adults
FACT: of the 1.4 million
individuals who sustain a Brain Injury
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50,000 die
-
235,000 are hospitalized
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1.1 million are treated and released from an
emergency department
-
*** the number of people with a Brain Injury who
are not seen in an emergency department or who
receive no care is unknown
Many of you are probably wondering
why is this happening and why haven’t you heard
about this before, the fact is many more individuals
are surviving a Brain Injury than ever before due to
improved medical technology and increased use of
seatbelts and helmets.
You can find these facts and much
more information by going to the web site for the
Brain Injury Association of America at
www.biausa.org or the local association for your
specific state.
State BI
Association Fact Sheets
CT
BIA
MA
BIA
ME
BIA
NH
BIA
RI
BIA
VT
BIA
***********
A traumatic brain
injury (TBI) is defined as a blow or jolt to the
head or a penetrating head injury that disrupts the
function of the brain. Not all blows or jolts to the
head result in a TBI. The severity of such an injury
may range from "mild," i.e., a brief
change in mental status or consciousness to
"severe," i.e., an extended period of
unconsciousness or amnesia after the injury. A TBI
can result in short or long-term problems with
independent function.
Of the 1.4 million
who sustain a TBI each year in the United States:
 | 50,000 die;
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| 235,000 are hospitalized; and
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| 1.1 million are treated and released from an
emergency department.1
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The number of people
with TBI who are not seen in an emergency department
or who receive no care is unknown.
The leading causes of
TBI are:
| Falls (28%);
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| Motor vehicle-traffic crashes (20%);
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| Struck by/against (19%); and
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| Assaults (11%).1
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Blasts are a leading
cause of TBI for active duty military personnel in
war zones.2
| Males are about 1.5 times as likely as females
to sustain a TBI.1
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| The two age groups at highest risk for TBI are
0 to 4 year olds and 15 to 19 year olds.1
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| Certain military duties (e.g., paratrooper)
increase the risk of sustaining a TBI.3
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| African Americans have the highest death rate
from TBI.1
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Direct medical costs
and indirect costs such as lost productivity of TBI
totaled an estimated $56.3 billion in the United
States in 1995.4
The Centers for
Disease Control and Prevention estimates that at
least 5.3 million Americans currently have a
long-term or lifelong need for help to perform
activities of daily living as a result of a TBI.5
According to one study, about 40% of those
hospitalized with a TBI had at least one unmet need
for services one year after their injury. The most
frequent unmet needs were:
| Improving memory and problem solving;
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| Managing stress and emotional upsets;
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| Controlling one's temper; and
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| Improving one's job skills.6
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TBI can cause a wide
range of functional changes affecting thinking,
sensation, language, and/or emotions. It can also
cause epilepsy and increase the risk for conditions
such as Alzheimer's disease, Parkinson's disease,
and other brain disorders that become more prevalent
with age.7
- Langlois JA, Rutland-Brown W, Thomas KE.
Traumatic brain injury in the United States:
emergency department visits, hospitalizations,
and deaths. Atlanta (GA): Centers for Disease
Control and Prevention, National Center for
Injury Prevention and Control; 2004.
- Defense and Veterans Brain Injury Center (DVBIC).
[unpublished]. Washington (DC): U.S. Department
of Defense; 2005.
- Ivins BJ, Schwab K, Warden D, Harvey S, Hoilien
M, Powell J, et al. Traumatic brain injury in
U.S. army paratroopers: prevalence and
character. Journal of Trauma Injury, Infection
and Critical Care 2003;55(4): 617-21.
- Thurman D. The epidemiology and economics of
head trauma. In: Miller L, Hayes R, editors.
Head trauma: basic, preclinical, and clinical
directions. New York (NY): Wiley and Sons; 2001.
- Thurman D, Alverson C, Dunn K, Guerrero J,
Sniezek J. Traumatic brain injury in the United
States: a public health perspective. Journal of
Head Trauma Rehabilitation 1999;14(6):602-15.
- Corrigan JD, Whiteneck G, Mellick D. Perceived
needs following traumatic brain injury. Journal
of Head Trauma Rehabilitation 2004;19(3):205-16.
- National Institute of Neurological Disorders
and Stroke. Traumatic brain injury: hope through
research. Bethesda (MD): National Institutes of
Health; 2002 Feb. NIH Publication No. 02-158.
Available from: www.ninds.nih.gov/disorders/tbi/detail_tbi.htm.
Resource:
http://www.biausa.org/elements/spacer2.gif
RESOURCES:
Glascow
Coma Scale
Rancho
Los Amigos Cognitive Scale Revised
Simplified
Brain Behavior Relationships
Brain
Map
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CMSNE 2007
Social Initiative - Heart Health
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This past year
CMSNE coordinated a year long Heart Health
Initiative in which the chapter provided educational
opportunities for our members.
As a wrap up to
this year long initiative we would like to recap our
activities:
The chapter
worked collaboratively with the American Heart
Association to share cardiac education materials
and identify speakers.
The American
Heart Association displayed at CMSNE’s two major
conferences.
The chapter
provided several educational programs to include:
- Stroke Rehabilitation and Technology
- Heart Failure - 21st Century Patient
Management
- Heart Health – Cardiac Update
- Update on Cardiovascular Prevention and Cardiac
Rehabilitation Options in Women
Education
regarding:
- Summary
of S.2278, the HEART for Women Act
- Heart Profiler
- Go Red for Women
- Gender Differences in Heart Disease
Heart Health
facts were passed out to attendees at each CMSNE
local chapter meeting.
Almost $2000 in
donations were made from chapter to the American
Heart Association, these donations were from
personal donations and speaker honorariums.
Karen Lytle,
CMSNE President Elect and the 2007 CMSNE Social
Initiative Chair wrote and published an article in
the August/September edition of Case In Point,
the article can be viewed at: http://caseinpoint.cmrg.com/2007august.pdf
The chapter
created a special web page on the CMSNE website,
dedicated to the Heart Health Initiative.
This coming year
CMSNE has identified Traumatic Brain Injury as it
year long social initiative. Plans are underway to
collaborate with each Statewide Brain Injury
Association, develop educational programs at both
the local and annual conference and to provide
ongoing education via CMSNE website, newsletters and
egroup blast. Stay tuned for additional details.
Did
You Know?
Heart
disease is the #1 killer of women, killing more
women than the next six causes of death combined?
That's
why the American Heart Association is celebrating
National Heart Month in February with a series of Go
Red For Women events. The Go Red For Women
campaign funds research around women and heart
disease and stroke, and it aims to educate women so
that they can lead longer, healthier lives. Find
out more at www.goredforwomen.org
or call
888-MY-HEART!
CMSNE
Heart
Healthy Initiative
American
Heart Association’s Community Partner Update
Childhood Obesity
Top 10 ways to keep your family healthy
America's
children are exercising less and getting heavier.
What gets in the way of kids building good health
habits as they grow? Peer pressure, failing to make
the right choices, watching TV or using the
computer, lack of supervision and lack of time. It's
up to the family to help children overcome these
hurdles to good health. Learn the top 10 ways that
families can help
children create heart-healthy habits.
Even if your kids aren't the athletic
type, there are ways to
get
them active.
Their health depends on it. They can ride bikes,
swim, skateboard or shoot hoops in the driveway.
It's a good idea to establish some time for the
family
to be active together.
Try walking with your kids, playing games outside or
simply turning on some groovy music that makes
everybody want to get up and dance.
Go Red For Women
Act with Your Heart! Advocates
Rally for HEART for Women Act
Waving red dress paper dolls and chanting, “HEART for
Women,” hundreds of You’re the Cure advocates called on Congress to pass the HEART for Women act, federal
legislation aimed at improving the prevention,
diagnosis, and treatment of heart disease in women.
More…
Currently, 205 Member of Congress have co–sponsored the
HEART for Women Act. To learn if your
legislators have signed–on in support, click
here.
Visit www.heartforwomen.org
to send a message to your legislators, asking them
to become co–sponsors.
Ask the Experts
Q.
I
am not overweight and in fact still look fit. Why
should I do any activity if I am naturally skinny?
A. Dr. Michael O’Donnell, Director of Health
and Wellness, Cleveland Clinic, Explains:
Weight control is only one of the health and fitness benefits
of being active. Keeping your heart healthy and your
muscles strong are just as important. There are many
stories of “naturally skinny” people having
heart attacks, strokes, high blood pressure, high
cholesterol and other cardiovascular problems.
A 2004 study of women published in the Journal of the American Medical
Association revealed that lack of activity was a
bigger predictor of heart disease for women than
being overweight or obese. (Source: The
Journal of the American Medical Association)
Other studies have shown that individuals live two
hours longer for every hour of regular exercise they
get. Fitness is just as important in skinny people
as it is in those who are overweight or obese.
Exercise and activity matters, regardless of your
weight. Daily physical activity has an
abundance of benefits. In fact, if there’s a
silver bullet or fountain
of youth,
it’s probably brisk walking. Brisk walking is the
easiest exercise to do, has the lowest dropout rate
and has the highest benefits of almost any type of
physical activity. Health benefits of walking
briskly at least 30 minutes a day on most days of
the week include:
·
Improves
blood circulation and reduces risk of heart disease
·
Helps
control weight
·
Improves
blood cholesterol levels
·
Prevents
and manages high blood pressure
·
Prevents
bone loss
·
Boosts
energy levels
·
Increases
muscle strength
·
Releases
tension and manages stress
·
Improves
ability to fall asleep quickly and sleep well
The Center for Disease Control recommends expending 3–6
METs, or 3–6 times the resting metabolic rate (RMR)
for health and fitness benefits. This range
corresponds to moderate relative intensity for most
young to middle-aged adults. Roughly speaking
vigorous exercise like jogging, for example,
requires greater than 6 METs and brisk walking
requires 3 or greater. (Source: "If you think
you’re workout is tough enough, it probably
is", AHA
Journal Report)
Related Links
Physical
inactivity and your heart
Regular
physical activity reduces your risk for stroke
By
Karen L. Lytle RN, CCM, CMC, CMSNE Director-at-Large
February/March
2007
As
this month’s excerpt from the American Heart
Association web page, let me introduce you to the
“Heart Profilers ™ Treatment Decision Tool”. This information is for providers and patients to provide
information on their cardiac status as well as
treatment options.
Please take the time to register and use
these free tools that were developed by the American
Heart Association and leading science and medical
experts. The
Heart Profilers ™
are known to be a trusted source of valuable
information.
Treatment
Decision Tools
The
American Heart Association’s Heart ProfilersTM
for the Professional are free tools that use a
patent pending search engine. Its technology
includes a Virtual Case Modeling system providing
more intuitive results than key word searches alone.
Heart Profilers
Help You
·
quickly find relevant, peer-reviewed
information on a case-by-case basis
·
use evidence-based research to make
better treatment decisions
·
be confident that the information you
are accessing is current and scientifically sound
Current
Topics Include
·
Atrial Fibrillation
·
Cholesterol
·
Coronary Artery Disease
·
Heart Failure
·
High Blood Pressure
Encourage
your patients to make informed treatment decisions.
Recommend the free Heart ProfilersTM
for patients. They are personalized,
self-paced, online educational tools for heart
disease patients, their families and caregivers.
These
Tools Provide Patients With
·
individualized patient-education
information specific to the patient’s unique
condition
·
easy-to-understand explanations of
treatment options
·
definitions and potential side effects
Patients
can
·
register online
·
complete a simple questionnaire using
information about their condition
·
receive a customized educational
report
·
bring the report to their next
appointment to discuss with you
Current
Topics Include
·
Atrial Fibrillation
·
·Cholesterol
·
Coronary Artery Disease
·
Heart Failure
·
High Blood Pressure
December/January
2007
It
is my pleasure to introduce to you “The Heart
Healthy Initiative” which will be brought to you
in several different methods. Plans are in the works
to present learning opportunities and speakers who
will give us the working knowledge to promote Heart
Healthy education and life changes that will benefit
our clients and ourselves as case managers in the
know.
It
is our goal to partnership with the American Heart
Association and local cardiologists, regional
facilities and other healthcare partners to bring
this valuable education to our members.
Many
of you may be familiar with the “Go Red For Women”
campaign that the American Heart Association has
brought awareness nationwide. Go Red For Women has
educated women and has empowered women to take
charge of their health and live longer, stronger
lives.
Heart
Disease and stroke are the No. 1 and No. 3 Killers
of women. That is more than the next seven causes of
death combined, including all forms of cancer.
It
is also our goal to invite speakers to our CMSNE
annual conference that will present information that
will provide tools to improve outcomes and guide our
clients through the preventative measure
recommendations and coordinate care as they recover
from cardiac events. For further information visit americanheart.org
As
a representative and Rl State President of Business
and Professional Women, I will be in Washington DC
February 8, 2007 to meet with women from across our
nation as well as members of the US House and
Senate to promote the passage of the Heart for Women
Act. This is a grassroot organization of working
women from all occupations whose mission is to
achieve equity for all women in the workplace
through advocacy, education and information.
Summary
of S.2278, the HEART for Women Act
The
legislation takes a 3-pronged approach to reducing
the heart disease death rate for women:
Education:
The bill would authorize the Department of Health
and Human Services to educate healthcare
professionals and older women about unique aspects
of care in the prevention, diagnosis and treatment
of women with heart disease and stroke
Analysis
and
Research: The bill would require that health
information that is already being reported to the
federal government be gender-specific and would
require annual recommendations to Congress for
eliminating disparities in, and improving the
treatment of, heart disease in women.
Screening:
The bill would authorize the expansion of the
Centers for Disease Control and Prevention's
WISEWOMAN program. The WISEWOMAN program
(Well-Integrated Screening and Evaluation for Women
Across the Nation) provides free heart disease and
stroke screening to low-income uninsured women, but
the program is currently limited to only 14 states
On
February 14, 2006, Senator Debbie Stabenow (D-Mt)
and Senator Lisa Murkowski (R-AK) introduced the
Heart Disease Education, Analysis and Research, and
Treatment (HEART) for Women Act. This bill would
improve the prevention, diagnosis, and treatment of
heart disease and stroke among women.
FACT:
Heart disease and stroke actually kill more women
each year than men.
FACT:
Heart disease, stroke, and other cardiovascular
diseases are the #1 killer in the United States and
in Michigan.
FACT:
Heart disease and stroke kill rnore women each year
than the next 5 causes of death combined, In fact,
cardiovascular disease kills nearly 12 times as many
women as breast cancer.
FACT:
In Michigan, 43% of all deaths in women are due to
cardiovascular disease's.
FACT:
1 in 3 adult women has some form of cardiovascular
disease.
FACT:
Minority women, particularly African American,
Hispanic and Native American women, are at even
greater risk from heart disease and stroke
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